April 4, 2006
Major Employers, Coalitions and Consumer Organizations Endorse New NCQA Physician and Hospital Quality Standards
Standards drive measurement, reporting of provider performance
WASHINGTON—More than two dozen of the nation’s largest employers and consumer groups, representing millions of Americans, have endorsed new standards released today by the National Committee for Quality Assurance (NCQA) that focus on how health plans measure the quality and efficiency of care provided by network physicians and hospitals, and how the plans share the results with their members to help inform consumer choice.
Health plans seeking distinction in Physician and Hospital Quality must demonstrate that they measure the quality and cost of in-network hospitals and physicians, and that, whenever possible, they act on information about cost in conjunction with information about quality. Plans must use results about both quality and cost to improve physician services through product design and by noting high-quality providers in online directories.
“Measuring physician and hospital performance is the next big step towards more transparent, accountable health care,” said NCQA President Margaret E. O’Kane. “The tremendous support from purchasers and consumer groups for these standards is a clear indication of the need for solid, reliable information about doctors and hospitals to help inform health care decision-making.”
EMPLOYERS AND EMPLOYER COALITIONS ENDORSING PHYSICIAN AND HOSPITAL QUALITY
- 3M Company
- The Boeing Company
- Bridges to Excellence
- Buyers Health Care Action Group
- California Public Employees'
Retirement System (CalPERS)
- Carlson Companies
- Cleveland State University
- DaimlerChrysler Corporation
- Eastman Chemical Company
- Ford Motor Company
- General Electric Company
- General Motors Corporation
- Human Resources Policy Association
- Kellogg Company
- Kennametal Worldwide
- Marriott International
- MidAtlantic Business Group on Health
- Midwest Business Group on Health
- National Business Coalition on Health
- National Business Group on Health
- New York Business Group on Health
- Pacific Business Group on Health
- St. Louis Area Business Health Coalition
- SYSCO Corporation
- UPS
- Wells Fargo & Company
- Xerox Corporation
CONSUMER AND HEALTH POLICY ORGANIZATIONS ENDORSING PHYSICIAN AND HOSPITAL QUALITY
- American Hospice Foundation
- Childbirth Connection
- Community Health Foundation of
Western and Central New York
- Consumer-Purchaser Disclosure
Project
- Consumers' CHECKBOOK/Center for
the Study of Services
- International Association of
Machinists and Aerospace Workers
- Leapfrog Group
- National Coalition for Cancer
Survivorship
- National Partnership for Women and
Families
The standards promote standardized, transparent measurement through the use of clinical measures of physician quality endorsed by the National Quality Forum (NQF) and the Ambulatory Care Quality Alliance, and hospital quality measures endorsed by NQF and the Hospital Quality Alliance. Both measure sets have received broad support from physician groups, consumer organizations, purchasers and health plans.
“Purchasers believe that transparency and performance incentives will dramatically improve quality and increase the value of the health care that they purchase,” said Robert S. Galvin, M.D., Director of Global Healthcare, General Electric Corporation. “With its new standards, NCQA has given purchasers the most valuable tool yet in helping them understand how health plans are performing in driving this critical agenda. Employers everywhere are excited about this breakthrough.”
Physician leaders noted the standards’ alignment with current measurement efforts, as well as their emphasis on collaboration. “These standards address a fundamental concern; the need for compatible and comparable data so that we avoid duplicative efforts and confusion,” said John Tooker, M.D., Executive Vice President and Chief Executive Officer of the American College of Physicians. “Because the Physician and Hospital Quality standards encourage plans to make use of measurement activities that are part of specialty board maintenance of certification activities, they may save time and avoid redundancy.”
“The first questions any physician should ask about a pay-for-performance program are, ‘What are the measures and how were they developed?’” added Bruce Bagley, M.D., Medical Director of Quality Improvement, American Academy of Family Physicians. “These standards encourage use of existing and widely accepted performance measures that were created with and by physicians, and require plans to work with physicians during the program development process — two essential elements of any effective physician level measurement initiative.”
Physician and Hospital Quality is the third content area of NCQA’s Quality Plus program. The first two content areas, Member Connections and Care Management and Health Improvement, were unveiled in 2005 to broad support from health plans and employers and consumers; to date, more than 125 surveys on the first two content areas have been scheduled.
The first surveys on the new Physician and Hospital Quality standards will begin as soon as July 1. Decisions on Physician and Hospital Quality surveys will be issued as early as the fourth quarter of 2006. Plans interested in becoming early adopters of the news standards are encouraged to visit NCQA’s Web site at http://www.ncqa.org/ for more information.
NCQA is a private, non-profit organization dedicated to improving health care quality. NCQA accredits and certifies a wide range of health care organizations, recognizes physicians for excellent care and manages the evolution of HEDIS, the tool the nation’s health plans use to measure and report on their performance. NCQA provides health care quality information free of charge through the Web and media in order to help consumers, employers and others make more informed health care choices.
ENDORSEMENTS OF PHYSICIAN AND HOSPITAL QUALITY
“The call from employers and consumers for individual provider performance measurement is loud and clear. Because such measurement is uniquely actionable, plans that produce it will enjoy substantial competitive advantage in marketing to larger employers and their employees.”
--Arnold Milstein, M.D., M.P.H., U.S. Healthcare Thought Leader, Mercer Health and
Benefits
“While measuring and reporting on the performance of doctors and hospitals is the keystone to any broader effort to improve the quality of health care, measurement for its own sake isn’t enough. These standards take the next step and ask plans to use the data to help doctors and hospitals fine-tune their practices.”
--Suzanne Delbanco, CEO, The Leapfrog Group
“The growth in consumer-driven plans highlights the need for a higher resolution picture of health care quality. As patients become more discerning consumers of health care, they will demand and need more detailed, objective data on doctors and hospitals to help them make better decisions.”
--Helen Darling, President, National Business Group on Health
“Each of us as customers of the health care system need and deserve standardized, usable information in order to make apples-to-apples comparisons and informed choices. Physician and Hospital Quality is a strong starting point for bringing plans, providers, purchasers and the public together as physician and hospital quality measurement moves forward.”
-- Dale Whitney, Corporate Health and Welfare Manager, UPS
“These standards are a strong step forward. Building on NCQA’s extensive experience with pay-for-performance, they provide the framework for the creation of robust provider-level measurement programs and align well with programs such as Bridges to Excellence.”
--Francois de Brantes, National Coordinator, Bridges to Excellence
“Today's patients are expected to take a more active role in health care decisions and deserve the most accurate and detailed quality information available to make these decisions. These standards help to define and provide the types of information that will empower patients and their families to make smart, informed decisions.”
--Debra Ness, President, National Partnership for Women and Families
“Establishing valid and comparable measures for health plans was the first step in preparing the healthcare market to respond effectively to its consumers - our employees and their dependents. These new measures take it one step further, helping employees make better-informed decisions about their doctors and hospitals. It gives our people the power of choice, which can help influence change in today's complex medical system.”
--Lawrence Becker, Director, Benefits, Xerox Corporation
"Human Resources executives are on the front line of our battle to improve health care quality while controlling costs. NCQA's new Physician and Hospital Quality standards will provide us with an important tool to inform employers, workers and families about the quality of the doctors and hospitals that care for them every day."
--John Butler, Executive Vice President, Chief Human Resources Officer, Textron
Inc.; Chairman, HR Policy Association Health Care Quality Reform Initiatives
“Traditionally, workers have few resources to rely on when choosing a doctor, especially when they relocate. They’ve had no choice but to ask neighbors and colleagues for their opinions, sometimes revealing personal health information in the process. These new standards introduce evidence-based data into the decision-making process for both workers and employers—a long-overdue development.”
--Larry Boress, President & CEO, Midwest Business Group on Health